Journal
OBESITY RESEARCH
Volume 11, Issue 2, Pages 176-182Publisher
NORTH AMER ASSOC STUDY OBESITY
DOI: 10.1038/oby.2003.28
Keywords
insulin resistance; pyruvate dehydrogenase kinase; biliopancreatic diversion
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Objective: The aim of this study was to verify whether changes in PDK4 mRNA expression in skeletal muscle in formerly obese subjects who underwent malabsorptive bariatric surgery [bilio-pancreatic diversion (BPD)] might be related to insulin sensitivity improvement, and if these possible modifications might correlate with a reduction of the intramyocytic lipid level. Research Methods and Procedures: Six obese women (body mass index 46.6 +/- 8.2 kg/m(2)) were enrolled in the study. Body composition, euglycemic-hyperinsulinemic clamp and muscle biopsies for skeletal muscle lipid analysis, and semiquantitative reverse transcriptase-polymerase chain reaction were performed before and 3 years after BPD. Results: The average weight loss observed after surgery was similar to42%. Increased glucose uptake was accompanied by a significant decrease of PDK4 mRNA (R-2 = 0.71, p < 0.001). The amounts of intramyocytic triglycerides correlate directly with PDK4 mRNA (R-2 = 0.87, p = 0.005) and inversely with glucose uptake values (R-2 = 0.75, p < 0.001). Discussion: Our results support the concept that a reduced tissue availability of fatty acids consequent to a massive lipid malabsorption influences glucose metabolism acting through the regulation of PDH complex. In fact, as shown in animals, a higher level of FFA availability is likely to induce overexpression of PDK4 also in humans.
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